Chesterfield Royal Hospital NHS Foundation Trust has published a tender notice for a patient administration system to replace its current system, which is reaching “end of life” in March 2014.
The tender, published in Official Journal of the European Union, says the trust wishes to procure a system that will be fully implemented by the time its contract for a McKesson PAS runs out.
The trust is one of 26 that were running McKesson’s Totalcare or STAR systems when NHS Connecting for Health signed a support deal with the company in 2006.
The deal recognised that delays to the National Programme for IT in the NHS would leave trusts needing to run their legacy systems until the ‘strategic’ Lorenzo EPR was ready.
The support deal ends in 2014, and a number of Midlands trusts have already issued tenders for PAS replacements. However, Chesterfield’s OJEU notice says the trust wants a system that can form the foundations of an electronic patient record.
“The system must interface to existing departmental systems during the initial transition and where necessary for the future. It is proposed that the successful system will be capable of forming the basis of an EPR system at a future date.”
The tender also indicates that the trust is interested in implementing a clinical portal, either from the winning PAS provider, or separately.
“The clinical portal should provide patient-context sensitive access to multiple clinical systems, initially within Chesterfield Royal Hospital, but potentially extending to other systems across the local community.”
The trust also requires the PAS to include hospital-wide patient management system functionality, outpatient clinic management, admitted patient care management, waiting list functionality, case note tracking, clinical coding as well as requiring a full data migration process.
Chesterfield’s annual plan 2011-2012 says that one of its main goals is to go and procure a new PAS. It underlines that new systems are needed not just because of the imminent end of the support contract, but to secure “further improvements to clinical care and business efficiency.”
Chesterfield implemented Totalcare in 1984. The trust’s tender notice says the new contract will be for an initial period of ten years, with the possibility of extension of up to five years, based on performance. The value of the tender is put at between £5m and £7.75m.
© 2012 EHealth Media.
Is it all too latenike 104 weeks ago
The trust have come out to procurement 15 months before the end of the current contract with McKesson who I think have been very clear on their intention not to extend support for TotalCare beyond March 14.
Having a strategy for full EPR solutions is all well and good but the reality is that Chesterfield will need 6-9 months for OJEU which will give a replacement supplier 6 months to introduce a new solution. As this is simply not long enough (The fastest recent example would be 11-12 months for a basis system) their vision may be broken from the start or at the very least it will have to be delivered in bite size chunks.
Where has it been done in 13 weeks?Daniel Defoe 102 weeks ago
Brighton, where it was actually also two separate PASs into one - the new PAS being neither of two existing PASs. And my understanding was that Bristol's implementation was 11 months from OJU to implementation which, of course, included the procurement time, but even so, Bristol's migration was very definitely a "PAS Plus", and not just a PAS.
Late-ishDaniel Defoe 104 weeks ago
Your timescales are a bit pessimistic nike. It's possible easily to complete a Restricted Procedure (which this is) in 13 weeks, start to finish. And bearing in mind that this is "only" a PAS, and not a "PAS Plus", albeit with a requirement for a great many interfaces, and depending on what data the Trusts expects to be migrated from its existing PAS to its new one, then migration and cutover, including training shouldn't take much more than another 13 weeks. There are many examples of PAS migrations taking less than this so I'm not sure about your "fastest recent example". Of course, it will all depend on good planning and project management, but if they can't hack it in the 15 months they've got available, then if I were Chief Executive, I'd be asking questions...
Bristol is what I was thinking ofnike 102 weeks ago
This was the fastest deployment of 'just PAS' I know about and this was 11 months. I am sure with no delay indecision making, taking only the minimum data set possible, and fully engaged Trust team then it could be done faster but where has it been done in 13 weeks?
Thanks for the explanationin arduis fidelis 104 weeks ago
Although from your explanation, and past experience, they seem to be creating a self defeating prophecy. If they don't buy in to an EPR and then push the supplier to develop the PAS side, the supplier won't be quite as keen to develop the EPR side if they have a nice little earner on continuing to supply PAS solutions that are being bought.
My feeling is that the "wait and see" attitude in secondary care is one of the big factors that has put them so far behind primary care in the area of EPRs.
Functionality again...Daniel Defoe 104 weeks ago
Simon, there's no need for an EPR supplier to "...develop the PAS side..."; the necessary functionality is already available in a true EPR. The difference is that an EPR is necessarily "patient-centric" and not "function-centric". To use the out-patient example again, until the EPR is universally implemented across an organisation, then the OP functionality of PAS will continue to be necessary right up until the last specialty (or whatever clinical or other operational metric you use) is using EPR for everything. And as it happens, "true" EPR suppliers don't also have a traditional PAS product to offer, so the "nice little earner" isn't actually there. To an extent, this is because EPR suppliers recognise that PAS as we know it is obsolescent, so there's no point in developing something that has a short life. But again, let's be clear, the credible available UK PASs at the moment are highly-developed, first-class, fit-for-purpose products which I suspect everybody, including their suppliers and developers know have a short but very useful life left, and which for most trusts will be measured in years rather than months.
Thanks for the clarificationin arduis fidelis 104 weeks ago
That clears up some of my confusion, if not my frustration that most of the advancements around the use of HI technology for sharing important patient information, data quality in coding of interventions, cradle to grave electronic patient records etc is available in Primary care but appears to be delayed by the lack of EPRs in secondary care (amongst other things).
Am I missing something here?in arduis fidelis 104 weeks ago
They want to move to an EPR system in the future but as their PAS is due to expire they want to purchase a new PAS on a 10 year contract with a possible extension of 5 years, so EPR in 15 years then - as the saying goes "don't put off till tomorrow etc, etc"..........
It's all down to functionality...Daniel Defoe 104 weeks ago
Simon, this is all down to the fact that experience shows there isn't an EPR on the market today which has all the plethora of functionality which has been built, over time, into existing UK PASs. By and large, the "PAS" element of available true EPRs includes only basic MPI and ADT functionality. Consequently, no trust in its right mind would consider introducing EPR without having in place a fully-functional PAS. Then, over time, as EPR functionality is implemented - and in a trust of any size, this is likely to take at least four years, and maybe longer - the functionality in PAS gets replaced by that in EPR (e.g., the curreent OP functionality in most PASs is replaced by the "Complex Scheduling" functionality inherent in an EPR etc). The other thing to bear in mind is that if it doesn't do something now, come March 2014, Chesterfield won't even have a PAS. A ten-year contract for a new PAS is, perhaps, a bit pessimistic, but again based on experience, it'll give Chesterfield another four or five years of "wait and see" before committing to a contract for an EPR. Although whether any trust will be able to meet the forthcoming demands of commissioners without an EPR, and thus still stay in business is another question entirely. But at least having a robust, modern PAS will give them half a chance...